Chemo ages us

Liezel

I was dx with Stage 3 bc at age 35.  2 years later, I have picked up about 10kg, and my body shape has changed completely.  DH thinks it is just because I ate more and stopped exercising during tx, but then I found this article.

Breast Cancer Chemo Changes Body Composition

Research Finds Women Gain Weight, Lose Lean Body Mass

Article date: 2001/05/15

For decades, researchers have noted that women newly diagnosed with breast cancer tend to gain weight, and that younger, premenopausal women treated with chemotherapy are at the greatest risk for weight gain. A recent study in the Journal of Clinical Oncology (Vol. 19, No. 9: 2381-2389) finds this phenomenon is related to lack of exercise and loss of lean body tissue, not overeating. Other studies have shown women receiving breast cancer chemotherapy typically gain five to 14 pounds. The study, the largest and longest of its kind, tracked 53 women for one year after breast cancer diagnosis, 36 of whom received chemotherapy as part of their treatment and the other 17, surgery with or without radiation. These researchers found the women who received chemotherapy gained an average of about five pounds over one year, compared to about two pounds in the women who had other treatment. But more significant than the weight itself, say researchers, is the kind of weight the women gained. While typical weight gain involves lean and fatty tissue, the chemotherapy-induced gain involved only fat, with perhaps even a loss of lean body mass. "It's not necessarily the weight gain, but the change in body composition that is really the thing that is worrisome," says lead author Wendy Demark-Wahnefried, PhD, a registered dietitian and associate research professor of surgery at Duke University Medical Center. She says the change in body composition is characteristic of the normal aging process. "If you look at these women in the year after diagnosis, the chemotherapy patient ages 10 years over the course of a year. Although you might think a change in of body fat of 2% is not much, indeed it is. The time clock is sped up." Weight gain not only affects quality of life, but may also predispose women to weight-related problems such as high blood pressure, cardiovascular disease and diabetes, researchers say. The women in this study's chemotherapy group also all developed premature menopause, which lasted the entire year. That could be partially responsible for the changes in their body composition, but researchers say their limited study couldn't determine for sure. The researchers found that the lean body mass losses occurred predominantly below the waist. Although breast cancer patients are encouraged to exercise to reduce nausea and fatigue, most recommendations concern aerobic exercise such as walking and biking. Demark-Wahnefried says strength training - especially focusing on the lower body - could provide even greater benefits. "We need more research to develop an exercise program that is very efficient in preserving this lean body mass," she says. Debbie Saslow, PhD, director of breast and cervical cancer for the American Cancer Society, agrees that larger, prospective studies are needed. "We need to find out what is the minimum exercise women could do that would help." She says it's also important that those who can't follow the recommendation don't feel anxious or guilty. Women with breast cancer who are interested in strength training programs should talk to their doctor first, especially before considering any upper-body conditioning. "We really don't know a lot about what brings on lymphedema (arm swelling). So we caution women about lifting weights - especially heavy weights - on their upper body," Saslow says. Demark-Wahnefried says science has yet to come up with an ideal program that preserves the lean tissue, but requires minimal stress on already-fatigued chemotherapy patients. But she says it's a worthy goal. "It's a lot easier to try to prevent lean tissue loss than to have the problem and try to cure it."

Although this makes me feel more normal, I am still sitting with the weight!!

Jani_

Hi Leizel!

I'm finished with all active treatment (yay!) and have started on Tamoxifen 17 days ago. No SE's yet, so holding thumbs!

I read some articles about weight-gain after treatment, and went to a dietician last week. Partly because I don't want to gain weight because of Tamoxifen, and partly because estrogen comes from fat cells as well.

She gave me some pointers on a low-fat diet (which is not too different to my normal diet).

As I said to her, I don't want to gain the weight, because I know I wont loose it again!

Janine

Anonymous

This article makes sense to me.